Thyroid Disorders

Thyroid gland is a small, butterfly-shaped gland located just below your Adam’s apple. The thyroid produces hormones that affect your body’s metabolism and energy level. Thyroid problems are among the most common medical conditions but, because their symptoms often appear gradually, they are commonly misdiagnosed.

The thyroid gland controls how quickly the body uses energy, makes proteins, and controls how sensitive the body should be to other hormones. It participates in these processes by producing thyroid hormones, the principal ones being triiodothyronine (T3) and thyroxine (T4). These hormones regulate the rate of metabolism and affect the growth and rate of function of many other systems in the body. T3 and T4 are synthesized from both iodine and tyrosine. The thyroid also produces calcitonin, which plays a role in calcium metabolism.

TSH measurement is the best means of determining thyroid dysfunction. Normal results essentially rule out hyperthyroidism or hypothyroidism.

The most common Thyroid disorders in clinical practice are Hypothyroidism, Hyperthryoidism, Hashimoto’s Thyroiditis, Goitre.

Hypothyroidism:

Hypothyroidism occurs at any age but is particularly common among the elderly. It occurs in close to 10% of women and 6% of men > 65. Although typically easy to diagnose in younger adults, it may be subtle and manifest atypically in the elderly.

Hypothyroidism is caused by thyroid hormone deficiency. It is chatacterised by Fatigue, Depression, Modest weight gain, Cold intolerance, Excessive sleepiness, Dry, coarse hair, Constipation, Dry skin, Muscle cramps, Increased cholesterol levels, Decreased concentration, Vague aches and pains, Swelling of the legs.

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Hyperthyroidism:

Hyperthryoidism is caused due to over production of thyroid hormones becuase of over active thyroid gland.

Hyperthyroidism is characterized by hypermetabolism and elevated serum levels of free thyroid hormones. Symptoms are many but include tachycardia, fatigue, weight loss, nervousness, and tremor.

Hyperthyroidism can be classified on the basis of thyroid radioactive iodine uptake and the presence or absence of circulating thyroid stimulators.

Graves Disease:

Graves’ disease, is caused by a generalized overactivity of the thyroid gland, is the most common cause of hyperthyroidism. In this condition, the thyroid gland usually loses the ability to respond to the normal control by the pituitary gland via TSH. Graves’ disease is hereditary and is up to five times more common among women than men. Graves’ disease is thought to be an autoimmune disease, and antibodies that are characteristic of the illness may be found in the blood. These antibodies include thyroid stimulating immunoglobulin (TSI antibodies), thyroid peroxidase antibodies (TPO), and TSH receptor antibodies. The triggers for Grave’s disease include:stress, smoking,radiation to the neck, medications and infectious organisms such as viruses.

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Functioning Adenoma and Toxic Multinodular Goiter

The thyroid gland becomes lumpier as we get older. In the majority of cases, these lumps do not produce thyroid hormones and require no treatment. Occasionally, a nodule may become “autonomous,” which means that it does not respond to pituitary regulation via TSH and produces thyroid hormones independently. This becomes more likely if the nodule is larger than 3 cm. When there is a single nodule that is independently producing thyroid hormones, it is called a functioning nodule. If there is more than one functioning nodule, the term toxic, multinodular goiter is used. Functioning nodules may be readily detected with a thyroid scan

Man Made Hyperthyroidism:

This type of disorder is a resultant of over use of thyroid supplementation either by mistake of a lack of follow up of a hypothyroid patient or purposeful excess intake of thyroid supplimentation for achieving goals like weight loss.

Thyroiditis (inflammation of the thyroid):

Inflammation of the thyroid gland may occur after a viral illness (subacute thyroiditis). This condition is association with a fever and a sore throat that is often painful on swallowing. The thyroid gland is also tender to touch. There may be generalized neck aches and pains. Inflammation of the gland with an accumulation of white blood cells known as lymphocytes may also occur. In both of these conditions, the inflammation leaves the thyroid gland “leaky,” so that the amount of thyroid hormone entering the blood is increased. Lymphocytic thyroiditis is most common after a pregnancy. Thyroiditis can be diagnosed by a thyroid scan.

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